Are dietary supplements getting better?
As we near the 25 year anniversary of the Dietary Supplement Health and Education Act, I think it’s a fair question to ask. DSHEA created an open, innovative market, one that is both growing strongly and has attracted lots of investment capital.
No one is really sure how many dietary supplements are on the market, but somewhere north of 50,000 seems a safe bet. What’s an even safer assumption is that there are at least 10 times as many as were on the market in 1994, the year DSHEA became law.
Most kinds of products improve. Have supplements?
With other categories of consumer goods, people have come to expect steady progress. The first widely available mass produced automobile, the 1908 Ford Model T, had a 20 hp, four cylinder engine. A little more than 25 years later, the same company produced the Lincoln Zephyr, with a 110 hp V12 engine. I could glean other examples of similar rapid progress from air travel, consumer electronics, and other fields.
I talked to an innovator a few years ago in the food space who used these examples to make the case for his invention, which was a nutritional polymer not found in nature. You wouldn’t be happy with a 1960s phone, would you? Why shouldn’t food products evolve, too?
With nutrition, the question is a bit more nuanced. Everyone would agree cars today are better than they were 25 years ago. They are faster, more efficient, quieter, safer, and those are all good things to have. But do we want ‘new’ food? Or do we want our red peppers to be just like those we remember from our youth?
So it begs the question of what do we mean by ‘better’ when it comes to supplements, which are a subset of food and, in the United States at least, are regulated as such. As I delve into this question over the course of this new weekly comment feature of ours, I’ve decided to break up the topic into more manageable chunks. Today, we’ll consider botanicals.
Most botanicals have a hisotry of use that stretches back hundreds or in some cases thousands of years. So there’s not much new under the sun in that sense; the active ingredients of the plants themselves haven’t changed, nor has their action in the body.
But our understanding of those actions has advanced by leaps and bounds. The practitioners of traditional herbal medicine systems had of course some understanding of the actions of these herbs. Those modes of action are now being categorized in Western medical terms, with a resultant much greater understanding of the potential of botanicals.
Much of this early work in the West was done in Germany by companies like Schwabe and others. The existience of a botanical medicine catetory there, a set of products on which claims can be made, was a big boost to that activity.
Now research has bloosmed in many areas of the world, particularly in China where more rigorous and more carefully designed studies are being done on botanical ingredients. These studies are now more often matching Western expectations of study design and proper characterization of study materials. The Noble Prize awarded to Chinese researcher Tu YouYou could be seen as a watershed event in this area. Tu won the prize for the discovery of artemisinin, an anti malaria drug. Consulting TCM texts reportedly formed the basis of her research journey.
In that sense, I think we could say that clearly the research underpinning of botanical supplements is better than it was 25 years ago. That is starting to be reflected in the formulations. There are more products on the market now that have dosages that reflect some research underpinning. Of course, ‘kitchen sink’ and ‘more is better’ approaches exist, too, but we’re talking long term trends here.
Adulteration exists, but efforts to expose it have increased
That leads us to the quesiton of how the products are made, and with what attention to quality. Mark Blumenthal, founder and executive director of the American Botanical Council, has been monitoring this question for decades, since before the time of DSHEA. Without large scale, baseline data on classes of products, he said it’s hard to say if fewer are adulterated today than in the past.
The problem continues to crop up, and to some extent is a symptom of the industry’s success, as more unscrupulous operaters seek to cash in. As Blumenthal has pointed out on many occasions, cheating is part of human nature, and there is evidence from antiquity of chiselers substituting in lower cost material to flesh out shipments of botanical products such as wine.
The signal of hope here is the existence of the Botanical Adulterants Prevention Program, a joint operation of ABC and the American Herbal Pharmacopoeia and the National Center for Natural Products Research. Through BAPP, formulators interested in quality know what adulterants to look for and have the analytical tools to find them.
And the communication about the benefits the products can provide to consumers has improved as well. A few years ago with a different employer I was involved in an effort to mine supplement advertisements from old magazines to potentially help companies prove the ODI status of their ingredients. I was struck with how crude the messaging in those adverts was. More companies today seem to understand what they are making and how to talk about their products in meaningful ways.
Consumers are voting with their wallets
So are herbal dietary supplements ‘better’ today than they were 25 years ago? If you look at outcomes, it’s a hard case to make. I don’t think you could argue that people by and large are healthier today for the explosion of herbal dietary supplements on the market than they were before DSHEA.
On the other hand, consumers are buying these products in increasing numbers, so they seem satisfied with they’re getting. I don’t buy the argument of some like Marion Nestle who seem to view this phenomenon as a case of mass psychosis. Fads do come and go, like pet rocks, singing fish or Crocs shoes. But once people wake up to the fact that these products don’t provide a lasting benefit, the fads evaporate. Categories of products that do provide a lasting benefit survive and prosper. I have to believe that all those millions of consumers who drove sales in the US to more than $8 billion for the first time are deriving real results from botanical products.
The best examples of herbal dietary supplements have improved in many significant ways. There is no reason to believe that won’t continue to be the case in the future.